Survey Helps Identify Vulnerable Patients With iNHL Patients Who Achieve Significant QOL Improvements

Indolent non-Hodgkin lymphomas (iNHL), while incurable, pose significant challenges in disease management, especially for adults over 65 who may experience frailty and functional impairments, according to research from the 66^th ASH Annual Meeting. The study investigated whether a high Vulnerable Elders Survey (VES-13) score (>3), indicative of vulnerability, is associated with changes in quality of life (QOL) among adults with iNHL across different age groups. Using data from the Lymphoma Epidemiology of Outcomes (LEO) Cohort Study, 1,186 participants with grade 1-3A follicular or marginal zone lymphoma completed VES-13 and QOL assessments at enrollment and 1- and 2-year follow-ups.

The QOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G), which evaluates physical (PWB), social/family (SFWB), emotional (EWB), and functional (FWB) well-being. According to Mazie Tsang, MD, and colleagues, baseline results revealed that participants with VES-13 scores greater than 3 had significantly lower FACT-G scores across all subscales than those with scores less than 3. In participants under 65, those with VES-13 greater than 3 experienced significant improvements in PWB and FWB at years 1 and 2, although emotional well-being declined in this group during the first year. Similarly, in participants over 65, higher VES-13 scores were associated with notable improvements in PWB, FWB, and overall FACT-G scores at both follow-up intervals. However, QOL in the vulnerable group consistently remained lower than in the non-vulnerable group.

The findings highlighted that vulnerable adults with iNHL, as identified by VES-13 greater than 3, demonstrated greater physical and functional well-being gains over time despite starting with lower overall QOL. These improvements were significant even after adjusting for baseline characteristics, including treatment strategy. However, emotional and social well-being showed no substantial differences between vulnerable and non-vulnerable groups over the study period.

“Although the vulnerable group reported worse QOL throughout the study period compared to the non-vulnerable group, survivors in the vulnerable group saw greater improvement in their physical and functional well-being at 1- and 2 years post-diagnosis,” Dr. Tsang and colleagues concluded.

“Additional analyses are underway to identify drivers of improvement in physical and functional well-being in vulnerable adults diagnosed with iNHL.”

Tsang M, Noble BN, Casulo C, et al. Vulnerable Elders Survey (VES-13) and Longitudinal Analysis of Quality of Life in Indolent Non-Hodgkin Lymphoma: A Multi-Institutional Prospective Cohort Study. Abstract 2345. Presented at ASH Annual Meeting. San Diego, CA.